There is an interesting survey published this month on mental health and substance use issues for law students. The Bar Examiner report (available here) found that a quarter of all law students had been diagnosed at some point for depression, anxiety, eating disorders, psychosis, personality disorder or substance use disorder. I am not surprised by the figure and speak every year to my classes about dealing the mental health and dependency issues as part of my first year classes. I try to tell them that there is no barrier to practice for students who have these issues. Indeed, the real danger is found among students who ignore these issues in the highly pressured legal profession.

There is one worrisome element in the study, though again not a surprising element. Forty-two percent of the surveyed law students said they thought they needed help in the past year for emotional or mental health problems, but only half of that group had actually received counseling from a health professional. In addition, only 4 percent had sought help from a health professional for drug or alcohol problems. That is the biggest problem facing law schools and bars. Law students and lawyers are often afraid to get help in the erroneous belief that either it could harm their standing in the profession or such problems means that they cannot be top practitioners.

The fact is that there are a large number of law professors and lawyers at the very top of our profession who have come forward to admit to such issues, particularly the very common problem of depression. The struggle with things like depression is dangerous is done without some assistance. The insidious aspect of depression is that it is an illness that robs people of the will to pursue recovery or awareness that they are really not in control. Many insist that they “can handle it” even though you can see that they cannot. As bad as a broken arm may be, the bone does not convince the victim to avoid medical treatment. Indeed, physical injuries give constant remainders of the need for treatment. Illnesses like depression distort the perspective of individuals who can reject the need for medication despite everyone around them begin them to accept the help. It is all the more tragic because these medications are now highly effective to return people to productive and fulfilling lives. The bar has a terrific record in supporting lawyers with mental health or dependency problems. I have seen both up close in both lawyer and non-lawyers.

What is remarkable about this survey is that it covered more than 3,300 law students at 15 law schools of different sizes and geographic locations responded to the survey, which included screening questions for depression and anxiety. The authors also found that twenty-three percent of the respondents screened positive for mild to moderate anxiety, and 14 percent screened positive for severe anxiety. Twenty-one percent said they had been diagnosed with anxiety at some point in their lives. Some 22 percent reported binge drinking two or more times in the prior two weeks. (Binge drinking is defined as five or more drinks in a row for men and four or more drinks in a row for women.)

This is an important report that I will be mentioning to my students in emails and in class this week. Once we can remove the stigma of such illness, we can make further strides in getting law students and lawyers the help that they need to live productive and happy lives.

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While you make some excellent and valid points regarding the external pressures associated with a law school education today and the impact that they have on the mental health of those pursuing said education–the enormous price tag and the surplus amount of attorneys in the job market–those are both facts which are “givens” going into the process and, if anything, people choosing to study law would be, in my opinion and in my experience, the opposite of what you deem fatalistic, foolhardy or desperate. When you remove those who decide to become lawyers just because three generations of attorneys precede them or those for whom dollar signs dance in their eyes, I would claim that the vast majority of these students are, instead, hopeful optimists, motivated dreamers and highly intelligent achievers–the opposite of fatalistic, foolhardy and desperate. Have you ever seen the film, The Paper Chase? That film debuted in 1973–over 40 years ago–where the external pressures that you list as part of the problem were hardly influencing factors, decades ago, with regard to the mental health of law students. While the film is a somewhat sanitized version of the real deal, it gives a small glimpse into what law students experience for the duration of their three years. Instead of focusing on a theory alleging that something inherent in the study of law, itself, attracts only the damaged and disturbed among us, why not focus on the law school experience and investigate what those institutions are doing to contribute to the problem? Not surprisingly, JT completely ignores what major part the professors, themselves, play in creating an environment which is taxing, unhealthy and toxic. Nothing, and I repeat, nothing, associated with the study of law is conducive to the manner in which many, although, not all, professors chose to impart the subject. Lawyer jokes aside, law school students are some of the best and the brightest, but prolonged exposure to the unnecessary and detrimental intense stress and strain would make even the most sane among us begin to lose it. Change the atmosphere, change the tactics and you can change the results. It’s fascinating that JT has no problem speaking with his students about these problems and their need to address them, but, the question is, does he have the same ability or willingness to speak with his fellow law school professors about changing their methods? Before one can speak about it, however, one must be able to recognize and acknowledge it as a contributing factor associated with, if not causing, the problem.

Law school was not stressful. It was fun. The best part of practicing law is doing jury trials. If you are not up to it do something else. Most lawyers do not try jury cases. The bulk of the tribe does divorces and bankruptcies.

Early on during my first semester of law school, I thought I was having asthma attacks. I went to the civilian on-campus physician who ran a number of tests on my lungs and heart.
The tests came back negative. Upon further examination, she concluded that I was having panic attacks and referred me to the psychiatrist and psychologist on staff. I must admit,
I was ignorant of panic attacks, and did not quite understand them. The psychologist and psychiatrist concluded that I had panic disorder and severe depression.
I was put on the antidepressant Lexapro and the anti-anxiety drug, Xanax.

Unfortunately, the depression and anxiety got worse over the next couple of months. I was diagnosed with insomnia and was taking Ambien in order to sleep.
The panic attacks and depression were physically incapacitating at times, which frightened and amazed me. I began to get headeaches accompanied with blurred vision,
nauseous, dizziness, ringing in my ears, and kept me in bed for hours at a time.

The stress of feeling as though I could not feel normal again, combined with the pain, was so bad that I was having suicidal thoughts and on my doctor’s advice, checked into a local ER.
After a couple of days of tests and pain relievers, I was released. On my doctors’ recommendation, as well as that of my parents, I withdrew from law school, though it was not what I wanted to do,
it was probably the best decision at the time.

I am reminded of that scene in “Trading Places” that takes place in the restroom off the bullpen of the Stock Exchange. Two guys are getting ready, one swigging alcohol straight from the bottle, the other popping pills, discussing the state of their ulcers.

Can the lawyers on the blog say which is more stressful, a court trial or law school? I would guess law school.

The question is whether a 25% prevalence among law students is high or low compared to the general population!

The incidence of depression alone in the U.S. is pegged at ~ 17%, so it might just be that when you add on anxiety, eating disorders, psychosis, personality disorder or substance use disorders, that making it to law school is actually protective of mental problems.

Having worked w/ attorneys for 40 years now, I know them pretty well. Law school sets the tone of their profession. As hellish law school is, being an associate in a large law firm is even worse. There are good law professors and law firm partners who treat young attorneys w/ dignity and empathy. But, they are the minority. The pathology is like that of an abused child, that child being much more likely to also be an abuser.

Before acclimating to the contradiction, the law student is confronted by the contradiction. Those that make it through the transition go on to make money. Some quit and some flip out. An analogy might be someone who is trying to become a doctor only to find what he or she really does is to save those who have money, prioritize the refusals and treatments of the rest, and try and keep a concerned, straight face throughout.

I’m not surprised by these findings, because today’s law students are necessarily much bigger risk takers, or perhaps simply more fatalistic, than those of previous generations. If one weighs the enormous cost of law school against the weak job market which is already saturated with lawyers, only the foolhardy or the desperate would invest in a legal education. I suspect that many of these students know, in the pits of their stomachs, that they are making a huge mistake, but like the guy who spends his rent money on lottery tickets, they’re just hoping against hope that it will somehow turn out okay. Hence the anxiety and depression.

There was a study, while I was in grad school, that posited that grad students, as a group, were far more mentally ill than any other group. However, the most examined group of people psychologically are freshman and grad students. It could be that they had not identified all the others yet. 🙂

This is a topic I have been highly motivated to do a considerable amount to educate myself on (my motivations will be clarified below)

And having done so I am of the opinion there should be a correction in this article: “…because these medications are highly effective…”, should instead read “…because, in many cases, these medications may be highly effective…”.

It is unfortunate that treatment resistance in true severe depression is all too common, as is the need to either cycle through several medications or combine a number of medications before finding something that will assist recovery, if traditional (SSRI,SNRI,Tricyclic,MAO-type,NERI,Stimulant,etc) medication assisted recovery has the possibility to help.

When conducting surveys like this however, the self reported data is often highly skewed as a tremendous number of people will confuse other emotional states such as unhappiness and grief with true depression.

I myself did this, thinking I was depressed, say after my first divorce for example, or after my grandfather died. And I continued to do up up until the point when I contracted RSD, where true severe depression is a hallmark symptom of the disorder. It was only after I had experienced how completely life destroying depression is, and how non-functional you can become that I could look back on those previous episodes and realize that what I experienced was nothing close, but the much more mundane emotions of sadness, unhappiness and grief – and yes, typical antidepressants helped me feel better at those times.

They have done nada for the depression (now, after 14 years, a disthymia) associated with the RSD/CRPS.

Fortunately there are other more radical treatment option available which are often highly effective for Tx resistant depression, however it is a tragedy that these treatments, although having MANY excellent, well designed, double blind, placebo controlled studies proving their effectiveness, are still considered experimental by insurers and there considerable expense is not covered.

These treatment options include:
• ketamine treatments – highly effective, though several treatments have to be done for lasting effect, and often periodic booster treatments may be needed for a while
• rTMS a kinder gentler treatment that has largely the same effectiveness of ECT.
• ECT having come a LONG ways from the cuckoo’s nest, using smaller charges and shorter durations with dramatically fewer side effects, for those who virtually nothing else will help it can be a godsend.

Personally, I only have experience with the Ketamine treatment, but at $500 per, I was not able to afford more than the single proof on concept treatment for myself, but the effect was almost magical for me, with dramatic reductions in both depression and pain levels (and when you have the most painful condition known to medicine – that’s miraculous); unfortunately the changes from a single treatment were short lived (only a few weeks).

I have no doubt that the tremendous pressures of law school create an enormous burden on the students pursuing that career. However I have some doubts that the self reported depression rates reflect true cases of depression, as the truly depressed would have an extremely difficult time meeting the demands of that high pressure environment, I would look amongst the law school drop-outs and those failing to find those who are clinically depressed and not experiencing other unhappy emotional states.

I will never forget it for as long as I live–the first day of law school, I went outside and sat on a bench to review some of my paperwork. A young man, who happened to be in his last year, took a seat at the other end of the bench and happened to ask if I was a first-year student. Proudly, and with all the joy and excitement that one embarking on a new and promising journey could muster, I said, yes. His answer? WELCOME TO HELL.

Having endured the unique thrill of law school, myself, I can attest to the fact that the experience is unlike anything that one can possibly imagine. When others have asked me to compare those three years to some other endeavor, try as I might, I am simply incapable of doing so, as nothing else, with which I am familiar, compares with the intense and never-ending levels of stress, anxiety and pressure artificially imposed upon the students by–you guessed it–the professors employed by the law schools, themselves. Granted, I have never, personally, experienced what it is like to be involved in an actual war or battle, but I can only say that the relentless fear and insidious pressure experienced by these law students must be somewhat akin to the experience of being involved in a state of battle for an extended period of time. I am not surprised by the findings mentioned in this article. Not surprised, at all, as I recall the mental breakdowns, substance abuse and suicide attempts of brilliant and talented classmates, who, ultimately, left law school for other pursuits. There is no comparison to what one experiences in college, at the undergraduate level–that is mere child’s play and is unfit to be used as any type of example to comprehend the law school experience. I mention all of this for a reason, and the reason is that this artificially imposed atmosphere of madness, fostered and imposed by the professors, themselves, is absolutely unnecessary and, if you ask me, counterproductive, for the study and comprehension of law. That’s right–unnecessary and counterproductive. There is nothing so unique about the study of law that requires, demands or merits what is inflicted upon those daring to choose the study of law. While JT can lecture his students about the need to address the depression, anxiety and substance abuse, which are so prevalent in law school, perhaps he could also turn some of his attention to his fellow colleagues and discuss ways in which they–the professors–who are responsible for much of the underlying pressure contributing to and fueling those problems–could learn to teach and impart the law without resorting to creating a toxic atmosphere? Want to truly solve, at least a portion of, the problem, JT? Go to the root of the matter–your fellow professors–and get them to ease up on the head games with which they gleefully participate and watch the incidences of depression, anxiety, substance abuse and suicide plummet.

Renegade You mad at me? LOL Normal is nothing to aspire to. Natural yes, normal no. Normal is the “norm” and let’s face it, America is #1 in Alzheimer’s Disease and many other really horrendous things. Don’t kill the messenger! I can give you a mountain of stats but it wouldn’t exactly make your day.

Case in point; today I arrived at my boss’ house this morning and spied a lovely ‘homemade’ blueberry muffin on the stove. Being the curious abnormal type I am, I picked up the box from which the muffins were made. On the front it said “NEW!!! CONTAINS BLUEBERRY FLAVORED BITS!” WOW. Artificial blueberries! Artificial color and flavor but somehow they’re still ‘blueberry’ muffins. You don’t find that funny? It is and it isn’t. People feed this sh*t to their kids and think nothing of it and when the whole family is going down the tubes from illness (and the ACA premiums) they never put two and two together. I could go on and on…. 🙂

Oh Hell, if you include all of those catagories of course you will find this to be true.
The problem is truth. Fat people can be lawyers and judges.
Randy Newmans’ song about short people does not apply to fat people.